Association of residential magnetic fields with contact voltage

The role of dwelling type when estimating the effect of magnetic fields on childhood leukemia in the California Power Line Study (CAPS)

PURPOSE

The type of dwelling where a child lives is an important factor when considering residential exposure to environmental agents. In this paper, we explore its role when estimating the potential effects of magnetic fields (MF) on leukemia using data from the California Power Line Study (CAPS). In this context, dwelling type could be a risk factor, a proxy for other risk factors, a cause of MF exposure, a confounder, an effect-measure modifier, or some combination.

METHODS

We obtained information on type of dwelling at birth on over 2,000 subjects. Using multivariable-adjusted logistic regression, we assessed whether dwelling type was a risk factor for childhood leukemia, which covariates and MF exposures were associated with dwelling type, and whether dwelling type was a potential confounder or an effect-measure modifier in the MF-leukemia relationship under the assumption of no-uncontrolled confounding.

RESULTS

A majority of children lived in single-family homes or duplexes (70%). Dwelling type was associated with race/ethnicity and socioeconomic status but not with childhood leukemia risk, after other adjustments, and did not alter the MF-leukemia relationship upon adjustment as a potential confounder. Stratification revealed potential effect-measure modification by dwelling type on the multiplicative scale.

CONCLUSION

Dwelling type does not appear to play a significant role in the MF-leukemia relationship in the CAPS dataset as a leukemia risk factor or confounder. Future research should explore the role of dwelling as an effect-measure modifier of the MF-leukemia association.

The relationship between residential magnetic fields and contact voltage: a pooled analysis

It has been suggested that residential exposure to contact currents may be more directly associated with the potential for an increased risk of leukemia in childhood than magnetic fields. Contact current exposure occurs when a child contacts a bathtub's water fixtures, which are usually contiguous with a residence's electrical ground, and when the drainpipe is conductive. The Northern California Childhood Leukemia Study (NCCLS) is the only epidemiological study known to address whether contact current may confound the reported association between residential magnetic fields and childhood leukemia. The study contributed contact voltage and magnetic-field data for over 500 residences of leukemia cases and control children. We combined these data with the results of previous measurement studies of contact voltage in other communities to conduct an analysis of the relationship of magnetic fields with contact voltage for a total sample of 702 residences. The Spearman correlation of magnetic field with contact voltage was 0.29 (Spearman, P < 0.0001). Magnetic-field and contact voltage data were both divided into tertiles, with an upper magnetic-field cutpoint of 0.3 μT suggested by values used in epidemiological results and an upper contact voltage cutpoint of 60 mV based on dosimetric considerations. Expressed as an exposure odds ratios (EOR), we report an association of contact voltage with magnetic fields of 15.1 (95% CI 3.6-61) as well as a statistically significant positive trend across magnetic-field strata (EOR of 4.2 per stratum with 95% CI 2.4-7.4). The associations appear to be large enough to support the possibility that contact current could be responsible for the association of childhood leukemia with magnetic fields.

Exposure to electrical contact currents and the risk of childhood leukemia

The objectives of this study were to examine the association between contact current exposure and the risk of childhood leukemia and to investigate the relationship between residential contact currents and magnetic fields. Indoor and outdoor contact voltage and magnetic-field measurements were collected for the diagnosis residence of 245 cases and 269 controls recruited in the Northern California Childhood Leukemia Study (2000-2007). Logistic regression techniques produced odds ratios (OR) adjusted for age, sex, Hispanic ethnicity, mother's race and household income. No statistically significant associations were seen between childhood leukemia and indoor contact voltage level [exposure ≥90th percentile (10.5 mV): OR  =  0.83, 95% confidence interval (CI): 0.45, 1.54], outdoor contact voltage level [exposure ≥90th percentile (291.2 mV): OR  =  0.89, 95% CI: 0.48, 1.63], or indoor magnetic-field levels (>0.20 µT: OR  =  0.76, 95% CI: 0.30, 1.93). Contact voltage was weakly correlated with magnetic field; correlation coefficients were r  =  0.10 (P  =  0.02) for indoor contact voltage and r  =  0.15 (P  =  0.001) for outdoor contact voltage. In conclusion, in this California population, there was no evidence of an association between childhood leukemia and exposure to contact currents or magnetic fields and a weak correlation between measures of contact current and magnetic fields.

Residential magnetic fields and measures of neutral-to-earth voltage: variability within and between residences

The objectives of this study were to characterize temporal patterns of magnetic fields (Bavg) and two measures of neutral-to-earth voltage: the voltage between the water line and earth (VW-E), and the voltage between bathtub plumbing fixtures and the drain (Vbath). The latter is a source of exposure to contact current in bathing children that has been proposed to explain the reported association between power-frequency magnetic fields and childhood leukemia. These quantities were measured each minute in a sample of 15 single-detached residences in San Jose, CA. Generally, Bavg, VW-E, and Vbath were positively correlated with each other within residences, and displayed similar diurnal patterns. Weekday and weekend patterns displayed qualitative differences that reflect the more scheduled workday for weekdays, and a less structured pattern for weekends. When pooled with two prior measurement studies, positive associations across residences between Bavg and both VW-E and Vbath were observed. Home designs over the past 30-40 years have lead to a decreasing prevalence of Vbath as conductive drains have been swapped out for non-conductive materials. Nonetheless, the observed relationships within and across residences indicate that contact current has the characteristics of a factor that could explain the association of magnetic fields with childhood leukemia.

Designs and analyses for exploring the relationship of magnetic fields to childhood leukaemia: a pilot project for the Danish National Birth Cohort

Pooled analyses have consistently displayed an association of childhood leukaemia with residential magnetic fields, even after attempting to account for study problems. In light of the serious possibility that the link is indeed causal, a study of possible joint effects (interactions) of magnetic fields and genetic cofactors on childhood leukaemia may be justifiable. Such a study would face serious obstacles of limited numbers for subgroup analysis. To address these obstacles, we describe a design and analysis strategy that combines multiphase (multistage) sampling, measurement error modelling, and Bayesian methods for subgroup analysis that incorporate information from earlier pooled analyses. Special attention is given to prior specification, which would be the potentially controversial element. The approach could be pilot tested on data from the Danish National Birth Cohort, but an informative study would require augmenting these data with case-control sampling. We conclude that the approach outlined may be of value not only for this topic but also in other studies of effects of rare exposures and genetic factors on rare outcomes.

Residence near power lines and mortality from neurodegenerative diseases: longitudinal study of the Swiss population

The relation between residential magnetic field exposure from power lines and mortality from neurodegenerative conditions was analyzed among 4.7 million persons of the Swiss National Cohort (linking mortality and census data), covering the period 2000-2005. Cox proportional hazard models were used to analyze the relation of living in the proximity of 220-380 kV power lines and the risk of death from neurodegenerative diseases, with adjustment for a range of potential confounders. Overall, the adjusted hazard ratio for Alzheimer's disease in persons living within 50 m of a 220-380 kV power line was 1.24 (95% confidence interval (CI): 0.80, 1.92) compared with persons who lived at a distance of 600 m or more. There was a dose-response relation with respect to years of residence in the immediate vicinity of power lines and Alzheimer's disease: Persons living at least 5 years within 50 m had an adjusted hazard ratio of 1.51 (95% CI: 0.91, 2.51), increasing to 1.78 (95% CI: 1.07, 2.96) with at least 10 years and to 2.00 (95% CI: 1.21, 3.33) with at least 15 years. The pattern was similar for senile dementia. There was little evidence for an increased risk of amyotrophic lateral sclerosis, Parkinson's disease, or multiple sclerosis.

Pilot measurements of ELF contact currents in some electric utility occupations

Contact currents from touching objects with different voltages can produce electric fields within the body that produce neurological and other biological effects. To begin measuring these exposures among electric utility workers, a new contact current meter (CCM) was tested in a pilot study at Southern California Edison. The CCM was worn for 82 full-shift measurements by 76 volunteers from eight occupations who did not work directly with energized electrical equipment. The volunteers were exposed to an average of 285.8 contact current events above the meter's 1-microA threshold, but most of these were electrostatic spark discharges. Fourteen employees experienced an average of 135.1 contact currents events whose primary frequency was 60 Hz. Using a circuit model of the human body, the average contact currents going from arm to arm was 9.8 microA (maximum = 178.0 microA), and the average going down the torso was 25.5 microA (maximum = 662.0). The maximum exposures were experienced by a technical support employee working in a substation. All measurements in this pilot study were below the 3000 microA maximum permissible exposure for contact currents set by the Institute of Electrical and Electronic Engineers (IEEE). Combining these current measurements with the results of high-resolution dosimetry, the internal electric fields averaged an estimated 1.7 mV/m in the heart (maximum = 21.0 mV/m), and 1.9 mV/m in the hematopoietic bone marrow in the torso (maximum = 56.5 mV/m). These internal electric fields from contact currents are below the basic restriction of 943 mV/m in the IEEE exposure standards but are above 1 mV/m, a level where biological effects have been often reported in laboratory studies. Safety concerns limited the measurements to de-energized equipment, so we did not obtain data on work in energized high-voltage environments, the most likely sources of high contact currents. This pilot study identified other improvements to the contact current meter that would make it better able to measure exposures in future health studies.

Biophysical Mechanisms: A Component in the Weight of Evidence for Health Effects of Power-Frequency Electric and Magnetic Fields

Comparatively high exposures to power-frequency electric and magnetic fields produce established biological effects that are explained by accepted mechanisms and that form the basis of exposure guidelines. Lower exposures to magnetic fields (< 1 microT average in the home) are classified as "possibly carcinogenic" on the basis of epidemiological studies of childhood leukemia. This classification takes into consideration largely negative laboratory data. Lack of biophysical mechanisms operating at such low levels also argues against causality. We survey around 20 biophysical mechanisms that have been proposed to explain effects at such low levels, with particular emphasis on plausibility: the principle that to produce biological effects, a mechanism must produce a "signal" larger than the "noise" that exists naturally. Some of the mechanisms are impossible, and some require specific conditions for which there is limited or no evidence as to their existence in a way that would make them relevant to human exposure. Others are predicted to become plausible above some level of field. We conclude that effects below 5 microT are implausible. At about 50 microT, no specific mechanism has been identified, but the basic problem of implausibility is removed. Above about 500 microT, there are established or likely effects from accepted mechanisms. The absence of a plausible biophysical mechanism at lower fields cannot be taken as proof that health effects of environmental electric and magnetic fields are impossible. Nevertheless, it is a relevant consideration in assessing the overall evidence on these fields.

50 Hz Magnetic Fields of 1 mT do not Promote Lymphoma Development in AKR/J Mice

Some epidemiological studies suggest that exposure to power-frequency magnetic fields increases the risk of leukemia, especially in children with high residential exposures. In contrast, most animal studies did not find a correlation between magnetic-field exposure and hematopoietic diseases. The present study was performed to investigate whether chronic, high-level (1 mT) magnetic-field exposure had an influence on lymphoma development in a mouse strain that is genetically predisposed to thymic lymphoblastic lymphoma. Three groups of 160 unrestrained female AKR/J mice were sham-exposed or exposed to sinusoidal 50 Hz magnetic fields beginning at the age of 12 weeks for 32 weeks, 7 days per week, either for 24 h per day or only during nighttime (12 h). Exposure was carried out in a blind design. Exposure did not affect survival time, body weight, lymphoma development or hematological parameters. The resulting data do not support the hypothesis that exposure to sinusoidal 50 Hz magnetic fields is a significant risk factor for hematopoietic diseases, even at this relatively high exposure level.

Selection bias and its implications for case-control studies: a case study of magnetic field exposure and childhood leukaemia

Based on the epidemiological association between residential exposure to extremely low frequency-magnetic fields (ELF-MF) and childhood leukaemia, the International Agency for Research on Cancer classified ELF-MF as a possible human carcinogen. Since clear supportive laboratory evidence is lacking and biophysical plausibility of carcinogenicity of MFs is questioned, a causal relationship between childhood leukaemia and magnetic field exposure is not established. Among the alternative explanations, selection bias in epidemiological studies of MFs seems to be the most plausible hypothesis. In reviewing the epidemiological literature on ELF-MF exposure and childhood leukaemia, we found evidence both for and against the existence of selection bias. To evaluate the potential for selection bias, we examined the relationship of socioeconomic status to subject participation and exposure to MFs. We find that, often, reporting of selection processes in itself is biased and incomplete, making the interpretation and evaluation of a potential for bias difficult. However, if present, such a bias would have wide implications for case-control studies in general. We call for better reporting and for evaluation of the potential for selection bias in all case-control studies, as well as, for the development of novel methods in control selection and recruitment.

Molecular change signal-to-noise criteria for interpreting experiments involving exposure of biological systems to weakly interacting electromagnetic fields

We describe an approach to aiding the design and interpretation of experiments involving biological effects of weakly interacting electromagnetic fields that range from steady (dc) to microwave frequencies. We propose that if known biophysical mechanisms cannot account for an inferred, underlying molecular change signal-to-noise ratio, (S/N)gen, of a observed result, then there are two interpretation choices: (1) there is an unknown biophysical mechanism with stronger coupling between the field exposure and the ongoing biochemical process, or (2) the experiment is responding to something other than the field exposure. Our approach is based on classical detection theory, the recognition that weakly interacting fields cannot break chemical bonds, and the consequence that such fields can only alter rates of ongoing, metabolically driven biochemical reactions, and transport processes. The approach includes both fundamental chemical noise (molecular shot noise) and other sources of competing chemical change, to be compared quantitatively to the field induced change for the basic case that the field alters a single step in a biochemical network. Consistent with pharmacology and toxicology, we estimate the molecular dose (mass associated with field induced molecular change per mass tissue) resulting from illustrative low frequency field exposures for the biophysical mechanism of voltage gated channels. For perspective, we then consider electric field-mediated delivery of small molecules across human skin and into individual cells. Specifically, we consider the examples of iontophoretic and electroporative delivery of fentanyl through skin and electroporative delivery of bleomycin into individual cells. The total delivered amount corresponds to a molecular change signal and the delivery variability corresponds to generalized chemical noise. Viewed broadly, biological effects due to nonionizing fields may include animal navigation, medical applications, and environmental hazards. Understanding necessary conditions for such effects can be based on a unified approach: quantitative comparison of the estimated chemical change due to a particular electromagnetic field exposure to that due to competing influences, with both estimates based on a biophysical mechanism model within the context of a model of a biological system.

Contact current hypothesis: Summary of results to date

Research conducted over the past 5 years has addressed the hypothesis that the reported association between residential magnetic fields and childhood leukemia may be explained by exposure to contact current. The use of multi-grounded neutrals in electrical distribution and residential electrical wiring systems in the United States results in a voltage on a residence's water line relative to earth that in turn creates a voltage between the water fixtures of a bathtub, sink, or shower and the drain, if the latter is made of conductive material. A bathing child may thus be exposed to contact current upon manual contact with the faucet, spout, or water stream. Dosimetry modeling indicates that modest and realistically anticipated currents (10s of microA) can produce electric fields in bone marrow (100s of mV/m) sufficient to overcome questions of biophysical plausibility. Both measurements in two regions of the United States and computer modeling of typical single-residence US neighborhoods indicate that residences with average magnetic fields in the high tail of the magnetic field distribution are more likely than residences with lower fields to also have higher contact voltage. The association of residential magnetic fields with contact voltage, the dosimetry results, and the indication from a behavioral survey that children tend to engage in behavior that results in exposure all support the hypothesis. Further research is needed to characterize electrical systems in other nations to determine whether contact current exposure occurs and whether it is associated with residential magnetic fields.